Jul 14, 2013 7:01 PM

I have been running pretty seriously now for just about a year now and it seems whenever I run, exercise or push myself in any way I get deep red circles around my eyes. I can have plenty of energy but I look like I'm ready to collapse. I checked with my doctor and he said he thought it was Rosacia but the only time he had seen it was a picture I took after a run.

I'm not sure if this is something I should try to address? Maybe it has to do with breathing and nasal cavities behind the eyes, or the dialation of blood vessels? I have had it mentioned by others after some hard runs and wonder if anyone else has experience with this they can share...?

Your Doc would probably want more symptoms to diagnose Rosacea. I think it was just a suggestion based on training in pathology that needs to be developed more. While it is most common in light-skinned women, a famous example of extreme Rosacea in men was W.C. Fields, whose bulbous nose was caused by the condition. One of my schoolmates had this disease, which in her case affected the skin above her cheeks, but not her eyes or nose. The Ocular type that affects mostly the eyes would more likely be accompanied by a number of other allergy-like symptoms, including irritation and blurred vision, and be more persistent throughout the day than so-called exercise allergies. You did not report these symptoms or circumstances in your account, but I think we're barking up the wrong tree.

If you were to run this by a coach, you would find redness around the eyes is pretty common among paler athletes. That does not mean there is no logical explanation or some way to deal with it. Let's explore common theories about how these circles occur so we can rule them out.

(1) Sun exposure during outdoor exercise affects delicate skin under the eyes more than thicker skin, in some fair-skinned people. If it happens during indoor exercise we can rule this theory out. If it only occurs outdoors, try carefully applying a sunscreen to the affected area, if the product directions allow this. A quicker solution is a good set of sunglasses.

(2) Nasal congestion, which can affect blood-flow around the eyes. Easy to test for this, but more difficult to trace the cause. Keep reading.

(3) Certain medications like inhalers or acne treatments can result in enhanced skin sensitivity. So can alcohol or caffeine. Discuss these with your doctor for possible side-effects if you are using them. Do not try to quit asthma treatments cold-turkey without such advice.

(4) Histamine over-reactions when exposed to allergens, which may be exacerbated by heavy breathing during exercise. Another one for your doctor. Since you probably can't avoid all allergens, and would not know where to start when eliminating them, an allergen test would be helpful. If that is out of the question, try eliminating the most common allergens (wheat, milk, nuts, etc.) from your diet for a few weeks and check the outcome. Airborne allergens could be eliminated by a good dust mask, but you'd look ridiculous running in it. Try this alone if you're curious.

(5) Certain types of bacteria on the skin can predispose one to redness. The skin around the eyes is not only thin, but moist, and it is known in dermatological circles that of the hundreds of bacteria that can be found on human skin, certain types thrive on certain parts of the body only. Once again, skin around the eyes is very different from other skin, and is likely to harbor unique microbes.

(6) Intestinal flora. Some have reported a reduction in symptoms after a course of anti-biotics that kill off gut bacteria. This is not necessarily because of particular strains of bacteria, but because the sheer numbers of them in the gut can overwhelm the immune system, resulting in an exaggerated immune system response. One of the theories behind pro-biotics, like some popular yogurts, fermented foods, and pills like acidophilus, is that one can supposedly re-populate the intestine with "friendly" bacteria. Unfortunately, there are at least three major types of strains or groupings of bacteria that favor certain individuals, apparently based on their genetic makeup, or on some other seemingly immutable factor. These internal eco-systems are still being researched, but until we know more, one person's favorite probiotic may not be the best for you. Something that tends to affect them all is what you eat. High-carb diets that runners favor can make certain gut bacteria go wild.

(7) Lack of sleep, for whatever reason, can thin the skin around your eyes, making natural flushing look unnatural during exercise. Aging can also have the same effect, but it pays to get enough shut-eye if you want to stay young-looking and improve your exercise performance. Remember that the more exercise you do, the more sleep you need. A good rule-of-thumb is an extra hour of sleep for each hour of exercise. Some professional athletes sleep 10 hours or more a day.

These suggestions should get you started. If it should turn out that you "have" Rosacea, it is more a condition, a pre-disposition, than a disease in the classical sense, and is still subject to the same sensitivities and cautions mentioned above. Good luck, and be prepared to accept this as a genetic trait, rather than a pathology, which means no big deal. You and your friends may be just fine after all.

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